National Provider Identifier [NPI]: |
1134115983 |
Last Name Of The Provider |
JENSEN |
First Name Of The Provider |
SUSAN |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1400 E BOULDER ST |
Street Address 2 Of The Provider |
STE 700 |
City Of The Provider |
COLORADO SPRINGS |
Zip Code Of The Provider |
809095533 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
46 |
Number Of Services |
3514 |
Number Of Medicare Beneficiaries |
1175 |
Total Submitted Charge Amount |
446565 |
Total Medicare Allowed Amount |
228150.59 |
Total Medicare Payment Amount |
164886.85 |
Total Medicare Standardized Payment Amount |
165383.91 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
46 |
Number Of Medical Services |
3514 |
Number Of Medicare Beneficiaries With Medical Services |
1175 |
Total Medical Submitted Charge Amount |
446565 |
Total Medical Medicare Allowed Amount |
228150.59 |
Total Medical Medicare Payment Amount |
164886.85 |
Total Medical Medicare Standardized Payment Amount |
165383.91 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
158 |
Number Of Beneficiaries Age 65 to 74 |
466 |
Number Of Beneficiaries Age 75 to 84 |
384 |
Number Of Beneficiaries Age Greater 84 |
167 |
Number Of Female Beneficiaries |
622 |
Number Of Male Beneficiaries |
553 |
Number Of Non Hispanic White Beneficiaries |
955 |
Number Of Black or African American Beneficiaries |
102 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
78 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
24 |
Number Of Beneficiaries With Medicare Only Entitlement |
986 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
189 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.31 |